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- W3184331312 abstract "Currently, 6 regimens are available for systemic chemotherapy for hepatocellular carcinoma. While it is significant that treatment options for advanced-stage HCC have expanded, it is also significant that the treatment strategy of the intermediate-stage (BCLC stage B) HCC which targets TACE has been changed. In particular, it is no exaggeration to say that lenvatinib has significantly changed the treatment strategy for the Intermediate stage. BCLC stage B is defined as follows; Child-Pugh A-B liver function and intrahepatic multiple tumors without vascular invasion or extrahepatic spread. Conventionally, TACE has been recommended for treatment of this stage. However, it has long been pointed out that this BCLC stage B is a heterogeneous tumor status that includes various tumor conditions, such as liver function (Child-Pugh score 5-7) and tumor burden (Up to 7 IN/OUT). Subclassification has been attempted using liver function, tumor burden and treatments have been subdivided for each substage. For BCLC stage B1 (Up-to-7 IN and Child-Pugh score 5-7), surgical resection or radiofrequency ablation (RFA) according to BCLC stage A, and super-selective lipiodol-TACE for curative intent is recommended. On the other hand, for BCLC StageB2 (Up-to-7 OUT and Child-Pugh score 5-7), molecular targeted therapy (MTT) is recommended instead of TACE. In particular, lenvatinib can achieve the downstaging by its higher tumor shrinkage effect and convert to curative treatment such as surgical resection, RFA or TACE. Also, lenvatinib is less likely to worsen hepatic reserve than TACE. The treatment strategy for BCLC stage B in which TACE was a standard of care is now changing dramatically by emergence of MTT. It is important to select the optimal treatment according to the tumor status with keeping in mind the preservation of liver function. It is significant that molecular-targeted agents have expanded the range of treatment options for intermediate-stage HCC." @default.
- W3184331312 created "2021-08-02" @default.
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- W3184331312 date "2021-07-01" @default.
- W3184331312 modified "2023-10-18" @default.
- W3184331312 title "SY26-3 Systemic chemotherapy for intermediate-stage hepatocellular carcinoma" @default.
- W3184331312 doi "https://doi.org/10.1016/j.annonc.2021.05.480" @default.
- W3184331312 hasPublicationYear "2021" @default.
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